切开复位内固定治疗急性和陈旧性隐匿性Lisfranc损伤的疗效
[Effectiveness of open reduction and internal fixation for acute and delayed occult Lisfranc injuries].
作者信息
Wu Shizhou, Qin Boquan, Xie Huiqi, Huang Fuguo, Zhang Hui
机构信息
West China School of Medicine, Sichuan University, Chengdu Sichuan, 610041, P.R.China.
Laboratory of Stem Cell and Tissue Engineering, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China.
出版信息
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2019 Aug 15;33(8):965-969. doi: 10.7507/1002-1892.201901004.
OBJECTIVE
To evaluate the effectiveness of open reduction and internal fixation (ORIF) in treatment of acute and delayed occult Lisfranc injuries.
METHODS
A retrospective review of 26 patients with occult Lisfranc injuries who were treated with ORIF between July 2010 and July 2015 was applied. Fourteen patients were treated within 6 weeks after injury (acute group) and 12 patients were treated after 6 weeks of injury (delayed group). There was no significant difference between the two groups in gender, age, affected sides, and preoperative visual analogue scale (VAS) score, American Orthopedic Foot and Ankle Society (AOFAS) score, and physical and mental scores of Study Short Form 12 Health Survey (SF-12) ( <0.05). The joint reduction, internal fixator, and traumatic osteoarthritis were observed by X-ray films. The pain degree, midfoot function, and quality of life were evaluated with VAS score, AOFAS score, and physical and mental scores of SF-12.
RESULTS
All incisions healed by first intention with no complications. All patients were followed up with the mean follow-up time of 15 months (range, 12-24 months) in acute group and 15 months (range, 12-23 months) in delayed group. At last follow-up, the VAS score, AOFAS score, and physical and mental scores of SF-12 were superior to those before operation in the two groups ( <0.05). And there was no significant difference in all indicators between the two groups ( >0.05). The satisfaction rates were 100% and 83.3% (10/12) in acute group and delayed group, respectively. The internal fixators were removed in 20 patients (11 cases in acute group and 9 cases in delayed group) at 9-24 months after operation (mean, 14.5 months). The results of X-ray films showed no traumatic osteoarthritis, midfoot collapse, internal fixation failure, or reduction loss during follow-up period.
CONCLUSION
ORIF is an ideal method for both acute and delayed occult Lisfranc injuries and can obtain the similar effectiveness.
目的
评估切开复位内固定术（ORIF）治疗急性和陈旧性隐匿性Lisfranc损伤的有效性。
方法
回顾性分析2010年7月至2015年7月间接受ORIF治疗的26例隐匿性Lisfranc损伤患者。14例患者在受伤后6周内接受治疗（急性组），12例患者在受伤6周后接受治疗（陈旧性组）。两组在性别、年龄、患侧、术前视觉模拟评分（VAS）、美国足踝外科协会（AOFAS）评分以及简明健康调查量表（SF-12）的生理和心理评分方面无显著差异（<0.05）。通过X线片观察关节复位情况、内固定器情况及创伤性骨关节炎情况。采用VAS评分、AOFAS评分以及SF-12的生理和心理评分评估疼痛程度、中足功能及生活质量。
结果
所有切口均一期愈合，无并发症发生。所有患者均获随访，急性组平均随访时间为15个月（范围12 - 24个月），陈旧性组平均随访时间为15个月（范围12 - 23个月）。末次随访时，两组患者的VAS评分、AOFAS评分以及SF-12的生理和心理评分均优于术前（<0.05）。两组各项指标间差异无统计学意义（>0.05）。急性组和陈旧性组的满意度分别为100%和83.3%（10/12）。20例患者（急性组11例，陈旧性组9例）于术后9 - 24个月（平均14.5个月）取出内固定器。X线片结果显示随访期间无创伤性骨关节炎、中足塌陷、内固定失败或复位丢失。
结论
ORIF是治疗急性和陈旧性隐匿性Lisfranc损伤的理想方法，且疗效相似。
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